Abstract:

Contraception has proven to be an effective way of controlling fertility and spacing births. Studies have shown that contraception can avert high risk pregnancies and consequently reduce maternal deaths. Uptake of modern contraception is promoted as a mechanism to address the reproductive health needs of men and women, as well as the crucial challenge of rapid population increase. Therefore, this study was conducted to assess the factors affecting the uptake of modern contraception services among women of reproductive age in Oyo state, Nigeria.

A cross sectional descriptive study using a two stage systematic sampling technique was used to select 530 women of reproductive age in five wards using sample size based on proportion to size in 20,000 households. Respondents were interviewed using a semi structured questionnaire which included questions on socio-demographic characteristics, awareness, knowledge, factors affecting the usage of modern contraceptives and perception of contraceptive use. Knowledge was assessed on a 5 point scale in which score of ≤ 2 were rated poor while perception was scored on a 36 point-scale in which scores ≤ 18 rated low. Data were analysed using descriptive statistics, Chi-square test and logistic regression at p=0.05.

Age of respondents was 30.3 ±7.8 years and 73.0% were married. Sixty percent were muslims and 34.5% had secondary education. Seventy two percent of the respondents were self-employed. About 90% had good knowledge of contraception while 60.8% had ever used contraceptives. The commonest source of information about contraception was mass media (72.8%). Twenty six percent obtained husbands’ approval before using contraceptives while 20.0% had used modern contraceptives before first birth. Fifty percent of the respondents agreed that contraception helps in improving standard of living and 64.7% had good perception about contraception. Factors that hindered effective uptake of contraceptive services included poor service providers’ attitude (33.3%) and congestion at the service centers (4.5%). Respondents with non-use of contraceptive before first birth were less likely to subsequently use contraceptives (OR= 0.324, 95%CI= 0.1-0.5). Husband’s approval of contraceptives use was the major determinant of women’s contraceptive use (OR = 3.4, 95%CI = 1.3-8.7). About 42.0% of the respondents had family planning centers not more than 5 kilometers walking distance to their residence. Twenty-one percent of those who had to take transportation to the service venues did not use contraception services.

Majority of the women in Ibadan North West were knowledgeable and aware of contraception services but husband’s approval on the use of modern contraceptives remains poor. Programmes that enhance husbands’ approval of modern contraception are thus recommended.

Keywords: Contraception uptake, Husband’s approval, Service provider’s attitude.

References:

[1].     Allen K, Larissa J, Alice R, Gorette N, James N, and Lynn A. (2014). Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women’s perceptions in two rural districts in Uganda. Available from: http://www.reproductive-health-journal.com/content/ [Accessed February 20, 2015].

[2].     Anyadike, N, and Emeh EJ (2012). Universal Journal of Education and General Studies Vol. 1(4); 088-102.

[3].     Best, Kim, (2002). Medical Barriers Often Unnecessary. Family Planning and Reproductive Health Behaviours in Nigeria Network 21(3): 4-15.

[4].     Campbell MM, Sahin-Hodoglugil NN, Potts M (2006). Barriers to fertility regulation: a Review of the literature. Studies in family planning; 37: 87-98.

[5].     Centre for Reproductive Rights and the Women Advocates Research and Documentation Centre (2008). Broken Promises: Human Rights, Accountability and Maternal Death in Nigeria. New York and Lagos. Journal of Adolescent Health, 12: 15-37.

[6].     Centre for Reproductive Rights and the Women Advocates Research and Documentation Centre. From http://www2.ohchr.org/english/bodies/cedaw/docs/ngos/CRR_Nigeria41.pdf [Retrieved December 1, 2012].

[7].     Federal Ministry of Health, (2004) Nigeria The health system in Nigeria and health status of Nigerians is in a deplorable state” (Health Sector Reform Programme, 2004–2007).

[8].     Federal Government of Nigeria (2006). The National Population Commission. Abuja: Federal Government of Nigeria.

[9].     Federal Republic of Nigeria Official Gazette. “Legal Notice on Publication of 2006 Census Final Results.” Official Gazette of the Federal Republic of Nigeria 96, No. 2 (February, 2009).

[10].  Finkle, C, Jacqueline ED, Susheela S (2011). Data analysis based on private communications The Allan Guttmacher Institute.

[11].  Frost JJ, Singh B, Finer LB (2007). Factors Associated with Contraceptive Use and Non -use, United States. Perspectives on Sexual and Reproductive Health, 39(2): 90-99.

[12].  Gaetano M, Lutuf A, Zaake D, Annika J. Predictors of Contraceptive use Among Female Adolescents in Ghana. African Journal Reproductive Health March. 2014; 18(1): 102. PubMed.

[13].  Garenne M, Tollman S, Kahn K (2000). Premarital fertility in rural South Africa: a challenge to existing population policy. Studies in Family Planning, 31:47–54.

[14].  Gebremariam A, Addissie A. Intention to use long acting and permanent contraceptive methods and factors affecting it among married women in Adigrat town, Tigray, Northern Ethiopia. Reprod Health. 2014 Mar 16; 11(1):24. PubMed.

[15].  Ghana Demographic and Health Survey (GDHS Ghana Trend Report. (2005). Trends in demographic, family planning and health indicators in Ghana, 1960-2003. Calverton, MD: ORC Macro.

[16].  Guttmacher Institute and International Planned Parenthood Federation. (2010). Facts on Satisfying the Need for Contraception in Developing Countries. In Brief. www.guttmacher.org/pubs/FB-Unmet need-Intl.pdf.

[17].  Guttmacher Institute, (2010). http://www.guttmacher.org/pubs/gpr/14/1/gpr140107.html

[18].  Guttmacher Institute (2004). The role of reproductive health providers in preventing HIV.

[19].  Issues in reproductive health, 19:14-16

[20].  Guttmacher Institute (2007). Facts on induced abortion worldwide http://www.who.int/reproductivehealth/publications/unsafe_abortion/abortion_facts.pd (Accessed on 02-12-12).

[21].  Guttmacher Institute. 2010. Facts on Investing in Family Planning and Maternal and Newborn Health. In Brief. www.guttmacher.org/pubs/ FB-AIU-summary.pdf.

[22].  Hamid S, Stephenson R. Provider and Health Facility Influences on Contraceptive Adoption in Urban Pakistan. Int Fam Plan Perspect. 2006; 32(2):71-78. PubMed.

[23].  Hotchkiss, D.R., R.J. Magnani, J.J. Rous, T.A. Mroz, M. Azelmat, and J. Heikel, (2009). The effects of maternal–child health service utilization on subsequent contraceptive use in Morroco. Journal of Biosocial Science 31(2): 145-165.

[24].  Johns Hopkins Bloomberg School of Public Health and Advance Family Planning. 2011. Taking Injectable Contraceptives to Villages: An Advocacy Case Study in Uganda [casestudy].www.advancefamilyplanning.org/system/files/Uganda%20CBD%20Case%20 Study%2010%2018%202011%20FINAL.pdf.

[25].  Johns Hopkins Bloomberg School of Public Health, Family Planning: A Global Handbook for Providers (Baltimore: Johns Hopkins Bloomberg School of Public Health, 2007), accessed online at www.infoforhealth.org/globalhandbook/index.shtml. 19. INFO Project, Family Planning: chapter 3.

[26].  Kaufman CE, de Wet T, Stadler J (2003). Adolescent pregnancy and parenthood in South Africa. Studies in Family Planning, 32:147–160.

[27].  Kolapo, Usman, Elizabeth Bunde, Erika Ronnow and Elizabeth Igharo. 2007. Nigeria: Contraceptive Logistics Management System Report. Arlington. : USAID DELIVER PROJECT.

[28].  Kishindo P 1995. Family Planning and the Malawian Male. Nordic Journal of African Studies, 4(1): 26-34. ARTICLE F https://www.unfpa.org/swp/1997/box10.htm.

[29].  Levin A, Caldwell BK, Barkat-e-Khuda “Demand for Family Planning Services in Rural Bangladesh: Effects of Cash Prices and Access”; Paper presented at IUSSP Seminar on Family Planning Programmes in the 21st Century; 2003; January 17 – 20; Dhaka, Bangladesh.

[30].  Lindroos A, Luukkainen A 2004. Antenatal Care and Maternal Mortality in Nigeria. From http://www.uku.fi/kansy/eng/antenal_care_nigeria.pdf (Retrieved November 7, 2010).

[31].  Magadi, A.M., and S.L. Curtis, 2003. “Trends and determinants of contraceptive method choice in Kenya”. Studies in Family Planning, 34(3): 149-159.

[32].  Martine C., Makeda G., and John C., “Non-Use and Use of Ineffective Methods of Contraception,” in Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, ed. Majid Ezzati et al. (Geneva: World Health Organization,2004): 1255-1320.

[33].  Meka A, Okwara EC, Meka AO. Contraception among bankers in an urban community in Lagos State, Nigeria. Pan Afr Med J. 2013; 14:80. PubMed.

[34].  Moronkola O, Ojediran M, Amosu A, Reproductive health knowledge, Beliefs and determinants of use among women attending Family planning clinics in Ibadan, Nigeria. Africa Health Sci 2006, 6:155-159.

[35].  National Population Council, (2012). Mainstreaming gender in States’ economic empowerment development strategy (SEEDS). Nigeria.

[36].  National Population Commission and Nigerian Urban Reproductive Health Initiative (NURHI), 2010‐2011 Baseline Household Survey for the Urban Reproductive Health Initiative (Chapel Hill, North Carolina: MLE, 2010).

[37].  National Population Commission [Nigeria] and ORC Macro. 2004. Nigeria Demographic and Health Survey 2003. Abuja, Nigeria: National Population Commission and ORC Macro. 25 – 26.

[38].  National Population Commission [Nigeria] and ICF Macro. 2009. Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro.

[39].  National Population Commission (NPC), Nigeria and ORC Macro. Nigeria Demographic and Health Survey2003 (Calverton, Maryland: National Population Commission and ORC Macro, 2004).

[40].  National Population Commission (NPC), Nigeria and ICF Macro. Nigeria Demographic and Health Survey 2008 (Calverton, Maryland: NPC and ICF Macro, 2009).

[41].  Odaman OM 2005. Some Socio-economic and Demographic Determinants of Family Planning Practice of Married Women in Ekpoma, Edo State, Nigeria. Iroro: A Journal of Arts, 10(1 and 2): 153-159.

[42].  Oladeji D 2008. Communication and Decision-Making Factors Influencing Couples’ Interest in Family Planning and Reproductive Health Behaviours in Nigeria. Studies of Tribes and Tribals, 6(2): 99-103.

[43].  Piotrow P, Treiman K, Rimon J, Yum S, Lozare B 1994. Strategies of Family Planning Promotion. Washington, D.C.: World Bank Technical Paper No. 223, P. 20.

[44].  Population Reference Bureau 2004. The Unfinished Agenda: Meeting the Need for Family Planning in Less Developed Countries. Washington D. C. Nigeria population council, 2006 population and housing census, Federal republic of Nigeria.

[45].  Population Reference Bureau (PRB), released March 16, 2009, in Washington, D.C. Family planning save lives of millions of women and children every year http://www.prb.org/Journalists/PressReleases/2009/familyplanning.aspx?p=1.

[46].  Raphael A 2008. Maternal death rate puts Nigeria in spotlight. From (Retrieved November 7, 2012).

[47].  Ross JA, Winfrey WL. (2002) Unmet need for contraception in the developing world and the former Soviet Union: an updated estimate. International family planning perspectives: 28; 138-43.

[48].  Ross J., and W. Winfrey. 2002a. “Contraceptive Use, Intention to Use and Unmet Need during the Extended Postpartum Period.” International Family Planning Perspectives 27 (1): 20–27.

[49].  Rimal RN, Ratzan SC, Arntson P, Freitmuth YS 2002. Reconceptualising the Patient: Health Care Promotion as Increasing Citizens’ Decision-Making Competencies. Communication, 9(1): 61-74.

[50].  Singh, S., J. E. Darroch, M. Vlassoff, and J. Nadeau. 2004. Adding it Up: The Benefits of Investing in Sexual and Reproductive Health Care. Washington, DC, and New York: The Alan Guttmacher Institute and the United Nations Population Fund.

[51].  Susheela Singh et al., Adding It Up: The Benefits of Investing in Sexual and Reproductive Health Care (New York: Guttmacher Institute and UNFPA, 2003).

[52].  Ugoji FN, 2008. Attitude of Undergraduates towards Contraceptive Use. Pakistan Journal of Social Sciences, 5(1): 111-115.

[53].  United Nations Population Fund (UNFPA). 2007. State of the world population 2007: Unleashing the Potential of Urban Growth. www.unfpa.org/swp/2007/presskit/pdf/sowp2007_eng.pdf. (Accessed on 10/01/2013)

[54].  United Nations Population Fund (UNFPA). 2005. “State of World Population 2005: The Promise of Equality—Gender Equity, Reproductive Health and the MDGs: Press Summary.” New York, NY: UNFPA. Available at http://www.unfpa.org/swp/2005/presskit/summary.html [accessed November 31, 20012].

[55].  WHO, The World Health Report, 2005: Make Every Mother and Child Count, Geneva: WHO, 2008, 2003.

[56].  World Health Organization, (2010). Update on family planning in Sub-Saharan Africa. In repositioning family Planning. Guideline for advocacy action. Pg 1-8 http://www.who.int/reproductivehealth/topics/family_planning/fp_advocacytool_kit.pdf (Accessed on 20 - 09 - 2012).

[57].  World Health Organization. 2007. Report of a WHO Technical Consultation on Birth Spacing Geneva: 1(2). 67-69.

[58].  World Health Organization. 2009. Unsafe Abortion: Global and regional estimates of incidence and associated mortality. 4th ed. Geneva WHO, 2004.